NPI | 1316007768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810000992) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000605) |
Enumeration Date | 2006-12-08 |
Last Update Date | 2007-07-08 |